基于证候积分——黄芪剂量关系应用补阳还五汤治疗缺血性卒中临床观察
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摘要
目的:探讨依据中医证候积分制定不同黄芪剂量的补阳还五汤治疗缺血性脑卒中的临床疗效,为临床治疗提供参考。方法:将120例缺血性卒中恢复期患者按随机数字表法分为治疗组和对照组各60例,均予常规药物及康复治疗,对照组统一加用120g黄芪剂量的补阳还五汤,治疗组采用中医证候评分表,根据积分由低到高,分别用60g,90g,120g黄芪剂量的补阳还五汤,疗程8周。分别比较2组临床疗效、NIHSS、改良Barthel指数及中医证候积分的变化。结果:2组治疗8周后,治疗组在临床疗效、NIHSS、改良Barthel指数及中医证候积分方面均较对照组明显改善,差异有统计学意义。结论:采用中医证候积分高低为依据,制定黄芪在补阳还五汤治疗缺血性卒中中用量的策略,能够提高临床疗效。
Objective: To explore the clinical efficacy of Buyang Huanwu Decoction in the treatment of ischemic stroke based on TCM syndrome scores,and to provide reference for clinical treatment.Methods: 120 patients with ischemic stroke recovery were randomly divided into treatment group and control group,60 cases were treated with conventional drugs and rehabilitation.The control group was treated with 120 g Huangqi dose of Buyang Huanwu decoction.The treatment group used the TCM syndrome score table.According to the score from low to high,60 g,90 g,120 g Huangqi dose of Buyang Huanwu decoction was used for 8 weeks.The clinical efficacy,NIHSS,modified Barthel index and TCM syndrome scores of the two groups were compared.Results: After 8 weeks of treatment in the 2 groups,the clinical efficacy,NIHSS,modified Barthel index and TCM syndrome scores of the treatment group were significantly improved compared with the control group,and the difference was statistically significant.Conclusion: Based on the high and low scores of TCM syndromes,the strategy of Astragalus membranaceus in the treatment of ischemic stroke with Buyang Huanwu decoction can be formulated to improve clinical efficacy.
Objective: To explore the clinical efficacy of Buyang Huanwu Decoction in the treatment of ischemic stroke based on TCM syndrome scores,and to provide reference for clinical treatment.Methods: 120 patients with ischemic stroke recovery were randomly divided into treatment group and control group,60 cases were treated with conventional drugs and rehabilitation.The control group was treated with 120 g Huangqi dose of Buyang Huanwu decoction.The treatment group used the TCM syndrome score table.According to the score from low to high,60 g,90 g,120 g Huangqi dose of Buyang Huanwu decoction was used for 8 weeks.The clinical efficacy,NIHSS,modified Barthel index and TCM syndrome scores of the two groups were compared.Results: After 8 weeks of treatment in the 2 groups,the clinical efficacy,NIHSS,modified Barthel index and TCM syndrome scores of the treatment group were significantly improved compared with the control group,and the difference was statistically significant.Conclusion: Based on the high and low scores of TCM syndromes,the strategy of Astragalus membranaceus in the treatment of ischemic stroke with Buyang Huanwu decoction can be formulated to improve clinical efficacy.
引文
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[2]WANG W,JIANG B,SUN H,et al.NESS-China Investigators.Prevalence,incidence,and mortality of stroke in China:results from a nationwide population-based survey of 480 687 adults[J].Circulation,2017,135:759-771.
[3]吴江.神经病学[M].北京:人民卫生出版社,2015:167-179.
[4]全国脑血管病会议.各类脑血管疾病诊断要点[J].中华神经科杂志,1996,29(6):379-380.
[5]国家中医药管理局脑病急症协作组.中风病诊断与疗效评定标准(试行)[S].北京中医药大学学报,1996,19(1):55-56.
[6]中华医学会神经病学分会脑血管病学组,王拥军,刘鸣,等.中国缺血性脑卒中和短暂性脑缺血发作二级预防指南2014[J].中华神经科杂志,2015,48(4):258-273.
[7]JUNG SM,CHOI WH.Effects of virtual reality intervention on upper limb motor function and activity of daily living in patients with lesions in different regions of the brain[J].J Phys Ther Sci,2017,29(12):2103-2106.
[8]喻腾云,吴艳华,孙寒静,等.缺血性脑卒中中医病因病机的层次关系[J].吉林中医药,2016,36(4):328-331.
[9]陶根鱼,杜晓泉.益气活血法在缺血性中风病中的地位[J].陕西中医学院学报,1998,21(3):1-2.
[10]肖诗鹰,王振海,全章安,等.缺血性中风、出血性中风与中医诊断的相关性研究[J].北京中医药大学学报,1996,19(1):53-54.
[11]朱丽,李静.不同剂量黄芪配伍的补阳还五汤对缺血性脑卒中患者血液流变学及疗效的影响[J].陕西中医,2014,35(9):1145-1147.
[12]周建英,姜海英,王明艳.益气活血方中黄芪不同剂量对缺血性脑损伤大鼠的脑保护作用观察[J].江苏中医药,2006,27(12):66-68.